Viewing blog posts tagged with "Metabolism"

The Surprising Similarities Between Anorexia and Obesity

posted by Julie O'Toole on January 28, 2015 at 10:14am

One thing I've observed over the years is that those readers who are interested in anorexia nervosa seem to have little interest in obesity, which they often seem regard as an lifestyle choice irrelevant to them, while those who study obesity often ask themselves what this rare condition (AN) has to do with their vastly more prevalent (read: important) condition of obesity (OB)? Quite a lot, as it turns out. And by the way, it’s worth repeating at the outset, neither condition is one…

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Tough Calls Parents Have To Make

posted by Julie O'Toole on January 21, 2015 at 9:17am

For people who are high achieving and successful, patience is typically not one of their long suits, especially when “patience” involves rest and restraint.

It’s not enough that our patients are often self-driven high achievers, but as this temperament trait is also highly heritable, many of our parents are as well.  It is not unusual for our kids to be valedictorians, salutatorians, the lead in the school play, talented musicians, or competitive dancers or athletes, whose efforts…

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The Dangers of Staying Slightly Below Weight

posted by Julie O'Toole on December 10, 2014 at 8:35am
I am a pediatric eating disorder doctor and try my best to limit my practice to patients 22 and younger. Why is this hard? Because I have a great treatment team and good treatment is hard to come by, so we sometimes run into deserving and desperate adult patients, whom we simply must refer to adult providers. I say this so that readers of this blog may put my recommendations into the context of the age group with which I am most familiar, although it is my opinion that this topic is… Read More

Eating Junk

posted by Julie O'Toole on June 26, 2014 at 1:12am

Recently a patient of ours returned from a treatment setting where she had been presented with “challenge foods”.  In her case she had been given cheetos and soda pop.  Now I ask you, why on earth would someone encourage a child to eat such a thing?

A lot of ink has been spilled on teaching Americans in general and children in particular to make good food choices.  Just because you have anorexia nervosa as a child, and desperately need to gain and maintain adequate weight, does not…

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Hard News About Exercise And Recovery

posted by Julie O'Toole on June 5, 2014 at 12:37am

I was recently sent an article from which I will be quoting extensively here (it’s also included in this newsletter - ed.). The article is by Heidi Mills, writing for Outside magazine and features the work of Dr. Emily Cooper of Seattle Performance Medicine. Dr. Cooper has consulted with Kartini Clinic on metabolic health and weight balancing for some time.  Originally, we worked together to try and solve the conundrum of patients with AN who appear to be weight restored but who…

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Thinking About Obesity

posted by Julie O'Toole on February 26, 2014 at 6:40pm

Thinking about obesity: calmly, rationally and outside the box

When I was a rotating intern at Sacred Heart Medical Center, long ago, I attended rounds with the then head of medicine Dr. Patrick Tennison. Dr. Tennison was a thin, dark haired, intense guy who years later would save my life, but at that time was obsessed with imbuing young doctors with a sense of urgency about diagnostic dilemmas. He was more like a highly competitive detective than your typical doctor.  

“The main…

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Weight Restoration 2.0

posted by Julie O'Toole on February 20, 2014 at 2:59am

At Kartini Clinic we have been embarking on something we call “weight restoration 2.0”.  In other words we are trying to move beyond mere weight restoration (as critical as that is) towards a deeper assessment of each patient’s full physical recovery.  We have noticed, over the years of faithfully weight restoring each and every patient, that people respond differently to recovery from starvation, depending no doubt on their genetics and on the duration of their illness. Just one…

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Eating for Life

posted by Julie O'Toole on November 27, 2013 at 11:59pm

A recent book by UCSF professor and pediatric endocrinologist Dr. Robert Lustig -- horridly titled Fat Chance -- has turned my mind to past discussions of our program’s dietary recommendations, aka the Kartini Meal Plan.

In its primary and original form the Kartini Meal Plan was developed to refeed children with restrictive eating disorders and weight loss following principles I have spoken about before: real food, cooked at home, eaten together in a spirit of joy.  Kartini’s Meal…

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